**1. Introduction**

Stroke is the fourth leading causes of death in the United States. Annually, about 795,000 people suffer from a stroke with about 140,000 people, or 1 in 19, dying each year due to stroke related causes. [1] Between 1995-2005 overall stroke death rate fell 30%, even so, annual health care related costs for stroke patients in 2012 were up to 38.6 billion. [1] It is well recognized that cerebrovascular disease, specifically carotid atherosclerosis and subsequent stenosis, is a leading cause of ischemic stroke, which makes up 87% of all strokes. Due to the significant morbidity and mortality incurred by these patients the identification, management, and treatment of carotid disease is of paramount importance.
